Stevens–Johnson syndrome as etiological factor in development of external auditory canal cholesteatoma: a case report

Stevens–Johnson syndrome and toxic epidermal necrolysis are severe acute mucocutaneous reactions driven by type IV hypersensitivity. Both conditions may be associated with medications or infectious agents. This article presents a clinical case involving a 26-year-old female patient who developed an external auditory canal cholesteatoma following an episode of Stevens–Johnson syndrome. The cholesteatoma presented for an extended time under the guise of otitis externa and was not diagnosed promptly, ultimately leading to extensive bilateral defect of the external auditory canal walls. Due to the limited coverage of otolaryngologic complications of Stevens–Johnson syndrome in the scientific sources, we additionally conducted a review of Russian and international publications addressing external auditory canal cholesteatoma associated with prior Stevens–Johnson syndrome or toxic epidermal necrolysis. External auditory canal cholesteatoma occurs in approximately 1 in 1000 otologic patients and accounts for 0.3% of all temporal bone cholesteatomas. It consists of desquamated stratified squamous epithelium and is characterized by progressive bone erosion. It may be classified as idiopathic, secondary, or associated with external auditory canal atresia. Clinical manifestations may include otorrhea and otalgia; however, in many cases, external auditory canal cholesteatoma may be asymptomatic. Surgical treatment is the only method of managing the disease that leads to its resolution and prevents potential complications.